| Corporation | |
|
1768 Nw 56th St Seattle WA 98107 | |
| (206) 784-5006 | |
| (206) 781-9329 |
| Full Name | Corporation |
|---|---|
| Speciality | Dentist |
| Location | 1768 Nw 56th St, Seattle, Washington |
| Authorized Official Name and Position | Elaine L Stone (OFFICE MANAGER) |
| Authorized Official Contact | 2067845006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Corporation 1768 Nw 56th St Seattle WA 98107 Ph: (206) 784-5006 | Corporation 1768 Nw 56th St Seattle WA 98107 Ph: (206) 784-5006 |
| NPI Number | 1881619385 |
|---|---|
| Provider Enumeration Date | 07/13/2006 |
| Last Update Date | 10/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881619385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DE00002430 (Washington) | Primary |
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